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Background/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.Methods: We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.Results: From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p

Irrigation scheduling techniques is one of the suggested solutions for water scarcity problem. The study aims to show the possibility of using practical and applicable irrigation scheduling program which was designed by Water Resources Department at the University of Baghdad by using Spreadsheet Formulas for Microsoft Excel program, version 2007, with some modification to generalize it and made it applicable to various climatic zone and different soil types, as a salvation for the shortage of irrigation water inside the irrigation projects. Irrigation projects which incidence of Tigris River basin will be taken as an applicable example. This program was based on water budgeting and programmed depending on scientific concepts which facilitate irrigation structures operation and ease the use by farmers. By using the abilities of this program, the monthly and annually water requirements and drainage water were estimated. Finally a comparison is made between the calculated discharges with the designers suggested ones. This comparisons showed that the use of this type of irrigation scheduling (i.e. predicted irrigation scheduling) with itsapplicable constrains require high attention when choosing the cropping pattern for each climate zone. Also it found that this irrigation program is a useful tool for saving water if cropping pattern has been chosen carefully.

Due to the development of communication and information technology, all organizations employ electronic communication to reach their customers and users, especially in developed nations where governments use e-government to support their residents with needed services. In Jordan, the use of e-government services is not as well adopted as in developed nations, because some Jordanians do not trust e-government services due to many reasons, which are discussed in this research; therefore, this study's goal is to determine dimensions that affect people's intentions to use e-government and its effect on e-government actual use in Jordan. The study looks into the factors that impact individuals' intentions and actual e-government usage, including attitudes toward behavior, credibility, and subjective norms that are derived from perceived usefulness, ease of use, awareness, trust in the government, incentives, trust in service delivery, transactional security, and social influence. A total of 352 online questionnaires were gathered, the majority of which were completed by college students who are between the ages of 18 and 29. The findings indicate that perceived ease of use, incentives, and perceived usefulness influence attitudes toward behavior, while awareness does not affect attitudes toward behavior. Trust in service delivery, transactional security, and trust in government affect credibility. Social influences affect subjective norms. Attitudes toward behavior and subjective norms affect intention to use, using intention affects actual usage, while credibility does not affect using intention. Finally, the results are helpful to Jordanian organizations including the Jordanian government. Recommendations are provided in the last section.

The Aim: The study aims to the possibility of depending on some immunological criteria (monocyte chemoattractant protein (MCP-1, MCP-3) and interleukin-18). Study Design: The study is indicators for early diagnosis of diabetic nephropathy in patients with type 2 diabetes and avoiding its development to advanced stages. Place and Duration of Study: Endocrinology Center / Al-Sadr Medical City and also Al-Manathira General Hospital / Al-Najaf Governorate, their ages ranged between (30- 60) years old, and the study continued for the period from 1/10/2022 to 31/3/2023 after obtaining the consent of the two study groups. Methodology: The study included the follow-up of (90) men, (30) healthy individuals and (60) patients with type 2 diabetes mellitus to periodic clinical examination ,the estimation of glycosylated hemoglobin ratio (HbA1c) and evaluation of immunological parameters represented in levels of monocyte chemoattractant protein (MCP-1 , MCP-3 ) and interleukin-18 . Results: The study diagnosed a significant increase (P < 0.05) in glycosylated hemoglobin ratio, monocyte chemoattractant protein MCP-1, MCP-3) and interleukin-18 ,and in contrast to a significant decrease (P < 0.05) in the glomerular filtration rate (GFR) in men with diabetes mellitus type II compared to healthy men. The study also showed a significant effect (P < 0.05) for the age groups on the glycosylated hemoglobin ratio and monocyte chemoattractant protein (MCP-3), and conversely a significant decline in the glomerular filtration rate (GFR) ,while no significant differences appeared (P > 0.05) in levels of monocyte chemoattractant protein (MCP-1) and interleukin-18. Also, a notable impact (P < 0.05) was observed for the duration of diabetes mellitus on the levels of monocyte chemoattractant protein (MCP-1 , MCP-3 ),whereas no substantial differences appeared (P > 0.05) in levels of glycosylated hemoglobin ratio, glomerular filtration rate (GFR) and interleukin-18. In addition to the foregoing, the trial recorded a significant influence (P < 0.05) of body mass index on the levels of monocyte chemoattractant protein (MCP-3),while no noticeable differences appeared (P > 0.05)in, the glycosylated hemoglobin ratio , glomerular filtration rate(GFR),and monocyte chemoattractant protein (MCP-1). Moreover, a significant effect (P < 0.05) for stages of diabetic nephropathy was diagnosed on the glycosylated hemoglobin ratio, monocyte chemoattractant protein (MCP-1, MCP-3), interleukin-18 and glomerular filtration rate (GFR). Conclusion: It is possible to depend on the increased levels of some immunological indicators especially MCP-1, MCP-3 and interleukin-18 as predictive biomarkers to diagnose the progression to advance stages of the diabetic nephropathy if this coincides with a decrease in the glomerular filtration rate.

We evaluated a protocolized endoscopic necrosectomy approach with a lumen-apposing metal stent (LAMS) in patients with large symptomatic walled-off pancreatic necrosis (WON) comprising significant necrotic content, with or without infection.Randomized trials have shown similar efficacy of endoscopic treatment compared to surgery for infected WON.We conducted a regulatory, prospective, multicenter single-arm clinical trial examining the efficacy and safety of endoscopic ultrasound (EUS)-guided LAMS with protocolized necrosectomy to treat symptomatic WON ≥ 6 cm in diameter with 30% solid necrosis. After LAMS placement, protocolized WON assessment was conducted and endoscopic necrosectomy was performed for insufficient WON size reduction and persistent symptoms. Patients with radiographic WON resolution to ≤ 3 cm and/or 60-day LAMS indwell had LAMS removal, then 6-month follow-up. Primary endpoints were probability of radiographic resolution by 60 days and procedure-related serious adverse events (SAEs).Forty consecutive patients were enrolled September 2018 - March 2020, of whom 27 (67.5%) were inpatients and 19 (47.5%) had clinical evidence of infection at their index procedure. Mean WON size was 15.0 ± 5.6 cm with mean 53.2% ± 16.7% solid necrosis. Radiographic WON resolution was seen in 97.5% (95% CI, 86.8%, 99.9%) by 60 days, without recurrence in 34 patients with 6-month follow-up data. Mean time to radiographic WON resolution was 34.1 ± 16.8 days. SAEs occurred in 3 patients (7.5%), including sepsis, vancomycin-resistant enterococcal bacteremia and shock, and upper gastrointestinal bleeding. There were no procedure-related deaths.EUS-guided drainage with protocolized endoscopic necrosectomy to treat large symptomatic or infected walled-off necrotic pancreatic collections was highly effective and safe. Clinicaltrials.gov no: NCT03525808.

Objective:A ventricular septal defect (VSD) is defined as a communication between the left and right ventricles or between the left ventricle and the right atrium. VSDs are amongst the most common abnormalities of the heart. They can be present in isolation or in association with other congenital cardiac abnormalities. This is study done with the aim to evaluate the types, size, associated CHD with ventricular septal defect in children and adolescent in two cardiac centers (Medical City Complex cardiac clinics, Ibn Al Nafaes teaching hospital) in Baghdad - Iraq Methods: Prospective cross sectional study based on echocardiography done pediatric cardiology centers and included all children and adult (birth to 25 years old) with VSD during period from 1st of October 2021 till 1st of July 2022. The examination performed in the lateral decubitus position using the echocardiography device (GE VIVID 9), transducer M6Sc-D and M5Sc-D. All patients were examined standard transthoracic echocardiography (TTE) including two dimensional, colors Doppler and M -mode. The standard technique was used to obtain the measurements. Size and type of VSD were examined in different standards four chambers, five chambers, parasternal long and short axis and subcostal views. The sample was divided into two groups, group 1 isolated VSD; and Group 2 associated with other CHD. The data collected for patients with ventricular septal defect and the age (from birth to 25 years old).A convenient sample of 206 patients with VSD was selected from consultancy clinics and wards of selected hospitals. Results: A total of 206 patients with ventricular septal defect were included in this study; 105 patients (51%) from Medical city complex, 101 patients (49%) from Ibn Al Nafeas teaching hospital. Males were 49% while females were 51%. The prevalence of isolated VSD 99(48%) and VSD associated with other CHD 107(52%). Symptomatic VSD were 60%, while Asymptomatic VSD diagnosed incidentally were 40%. The most common type of VSD was Perimembranous 73 followed by muscular 19%, Inlet (canal type) 7% and Outlet (subarterial) Subpulmonic VSD 1% respect. The most common associated CHD was PDA 33 (30.8%), followed by ASD Secundum 30 (28%), PS 10 (9.3%), Coarctation of aorta 8 (7.4%), MR 7(6.5%), TOF 6 (5.6%), Atrioventricular canal defect 3 (2.8%), DORV 2 ( 1.8%) and each of L-TGA, DTGA, Dextrocardia , truncus arteriosus and tricuspid atrasia had 1 (1%). Conclusions: The most common VSD type of studied patients is perimembranous in followed by muscular, inlet type and the less common is outlet. Although multifactorial, Consanguinity marriage with positive family history plays a great role of recurrent CHD in families.

We report on the variation of electric power density linked to very low frequency (VLF) signal observed during the minimum of solar cycle 25. The detected VLF signal is emitted by the NWC radio station localized in the southern hemisphere, at 21.5∘ S and 114.2∘ E. We attempt in this work to quantify the beam as detected by the Electric Field Detector (EFD) instrument onboard CSES satellite. Geometrical key parameters have been considered to analysis the variation of the power density taking into consideration the distance between the satellite trajectory and the NWC station and its conjugate region. The beam behavior is found to be subject to significant disturbances in the conjugate region with the presence of signal modulations. Above the NWC transmitter station, the beam can be considered as a hollow cone but with irregularity dependence on the electric power density.

In Iraq, breast cancer is considered one of the most widespread cancer types causing death in women due to changes in the genes that control cell growth and proliferation. KRAS gene plays a role in 30% of human cancers. This study aims to evaluate the expression of the KRAS gene and its role in women with breast tumours. A total of 120 women (60 women with breast tumours and 60 samples from apparently healthy women) were enrolled in this study to determine the expression of the KRAS gene. The RT-qPCR was used for this purpose. Fibroadenoma (FA) was the most common tumours, accounting for 53% of cases, followed by fibrocystic change (26%). Other benign tumours accounted for 20% of the cases; however, IDC is the most common type of invasive breast cancer, accounting for 70% of all breast cancers. Moreover, KRAS gene expression in women with breast tumours (benign and malignant) was not- significantly different from that seen in normal healthy women.

A new Maximum Power Point Tracking (MPPT) method, consisting in combining the Incremental Conductance (INC) algorithm with the Hysteresis control, was developed and applied to a standalone photovoltaic (PV) system to generate the maximum power of the PV array. The INC allows one to search for the Maximum Power Point (MPP). The hysteresis improves the accuracy of tracking the MPP very fast even after severe changes in weather conditions and has no oscillations around the MPP. The five-level S-Packed U Cells (SPUC5) inverter is used to transform the produced DC voltage to AC voltage; it generates five-level output voltage with a small number of switches and only DC source voltage. The capacitors of the SPUC5 are controlled by the Pulse Width Modulation (PWM) in order to balance their voltages. The proposed PV system was established and trained in the MATLAB/Simulink environment under various irradiation conditions. A comparison between different MPPT methods, INC-PWM and INC-PI, was investigated in order to examine the effectiveness of the developed MPPT technique in particular, and of all the PV system components. The results of the simulation validate the effectiveness of the suggested MPPT algorithm as well as the used SPUC5 inverter.

The structural properties of (Ag-NPs) nanoparticles prepared by the chemical method were examined using (XRD) diffraction. Additionally, the optical properties were tested using a UV-Vis spectroscopy instrument, and a scanning electron microscope was used to analyze the surface morphology, We found that (Ag-NPs) nanoparticles have the highest absorbance at wavelengths of (400)nm and that the granular size of these material ranges between (29 – 89)nm. And The morphology analysis further revealed that (Ag-NPs) particles are spherical in shape.

EUS-directed transgastric ERCP (EDGE) is an established method for managing pancreaticobiliary pathology in Roux-en-Y gastric bypass patients, with high rates of technical success and low rates of serious adverse events (AEs). However, widespread adoption of the technique has been limited because of concerns about the development of persistent gastrogastric or jejunogastric fistulas. Gastrogastric and jejunogastric fistulas have been reported in up to 20% of cases in some series, but predictive risk factors and long-term management and outcomes are lacking. Therefore, our aims were to assess factors associated with the development of persistent fistulas and the technical success of endoscopic fistula closure.This is a case-control study involving 9 centers (8 USA, 1 Europe) from February 2015 to September 2021. Cases of persistent fistulas were defined as endoscopic or imaging evidence of fistula more than 8 weeks after lumen-apposing metal stent (LAMS) removal. Control subjects were defined as endoscopic or imaging confirmation of no fistula more than 8 weeks after LAMS removal. AEs were defined and graded according to the American Society for Gastrointestinal Endoscopy lexicon.Twenty-five patients identified to have evidence of a persistent fistula on follow-up surveillance (cases) were matched with 50 patients with no evidence of a persistent fistula on follow-up surveillance (control subjects) based on age and sex. Mean LAMS dwell time was 74.7 ± 106.2 days. After LAMS removal, argon plasma coagulation (APC) ablation of the fistula was performed in 46 patients (61.3%). Primary closure of the fistula was performed in 26.7% of patients (20: endoscopic suturing in 17, endoscopic tacking in 2, and over-the-scope clips + endoscopic suturing in 1). When comparing cases with control subjects, there was no difference in baseline demographics, fistula site, LAMS size, or primary closure frequency between the 2 groups (P.05). However, in the persistent fistula group, the mean LAMS dwell time was significantly longer (127 vs 48 days, P = .02) and more patients had ≥5% total body weight gain (33.3% vs 10.3%, P = .03). LAMS dwell time was a significant predictor of persistent fistula (odds ratio, 4.5 after40 days in situ, P = .01). The odds of developing a persistent fistula increased by 9.5% for every 7 days the LAMS was left in situ. In patients with a persistent fistula, endoscopic closure was attempted in 19 (76%) with successful resolution in 14 (73.7%).Longer LAMS dwell time was found to be associated with a higher risk of persistent fistulas in EDGE patients. APC or primary closure of the fistula on LAMS removal was not found to be protective against developing a persistent fistula, which, if present, can be effectively managed through endoscopic closure in most cases.

In this paper, limestone quarries in the Bazian region, west of Sulaymaniyah city, northern Iraq, were evaluated geotechnically to examine their suitability for developing asphalt concrete for the top layer of roadways. Two samples were collected to perform geotechnical testing, including physical, chemical, and permanence tests. From the physical results, it is evident that the coarse and fine aggregate grain sizes demonstrated conformity to the American Society for Testing and Materials ASTM-C136 as well as the requirements of the fine aggregate standards ASTM-C117, which fall within the coarse, fine, and filler areas. Moreover, the findings revealed that the flat granules are 22% and the longitudinal granules are 35%. Based on these results, it did not go over the limits set by British standards, so it meets the requirements for concrete work. Another promising finding of durability tests was 21.8%, which represented the highest weight loss. This is an important finding in the understanding of the suitability of the aggregate to American and Iraqi standards in concrete work. A further novel finding of stability tests demonstrated the cement's suitability with Iraqi standards and the American standard C131-C535-2003. Finally, the results of Marshall's test for density, creep, and stability reveals the conformity with the Iraqi specification for asphalt concrete works D2726-05, where the density value was 2.292 and the percentages of creep and stability were 12.2 kN and 2.9 mm, respectively. The results of examining the cement asphalt were in accordance with the specifications required for concrete works, where the optimum percentage of asphalt for the design of the asphalt mixture for the surface layer was 4.8. Also, the percentage of airspace was 4.1 according to the American standard D2041.

AIM: To determine the possibility of using analgonociception monitoring (analgesia nociception index, ANI) to assess the need for postoperative analgesia in patients with prolonged impairment of consciousness. MATERIAL AND METHODS: This pilot prospective randomized study enrolled 34 consecutive patients with chronic impairment of consciousness (vegetative state/minimal state of consciousness) who underwent neurosurgical interventions. Randomization was made by the envelope method for the grouping of the patients: study group (SG, n=17), received anesthesia with intravenous paracetamol 1000 mg according to ANI in the postoperative period; control group (CG, n=17), without additional anesthesia in the postoperative period. Patients with arrhythmias were excluded. The groups are comparable in terms of the main clinical parameters (all parameters p 0.05). The ANI (MetroDoloris device, France) was recorded at 1, 4, 8, 12, and 24 h after surgery. The valuation was based on the revised scale for assessing pain in a coma, i.e., Nociception Coma ScaleRevised (NCS-R) [7], after 4, 12, and 24 h. RESULTS: An intragroup comparison of the changes in ANI during postoperative day 1 showed an adequate level of pain relief (60.1 [55.362.5]), whereas in the group without postoperative analgesia with paracetamol, by 4 h after the operation, ANI dropped to the lower limit (46.3 [40.251.9]). In an intergroup comparison in the first 8 h after surgery, ANI was significantly higher than in the group without anesthesia (p=0.04) and had values of 55, which indicates the absence of pronounced vegetative reactions indicating the presence of pain. From 12 oclock, the values are leveled out, not going beyond the limits of indicators of inadequate anesthesia (p=0.69). When assessing nociception on the NCR-R scale during the postoperative day in both groups, a tendency to the appearance of weak autonomic responses was observed (6 [5; 8] in SG and 6 [5; 7] in CS, respectively), which did not differ significantly. The presence of pain 4 h after surgery was confirmed by increased levels of cortisol and salivary alpha-amylase in patients without postoperative analgesia (p=0.03). CONCLUSION: No generally recognized and available evidence-based instrumental methods are available for the assessment of pain intensity in patients with chronic impairment of consciousness. There is no single position of the professional community on the need for postoperative analgesia in such patients. Further studies to evaluate the effectiveness of using the ANI Metro Doloris monitoring system with a significant number of observations will lead to the determination of adequate perioperative analgesia regimens in patients with various forms of prolonged impairment of consciousness.

This letter applies a multi-agent fuzzy Q-learning algorithm, incorporated with a model-free non-linear controller, entitled FQL-MFNC for stabilized controlling of a recently introduced grid-connected nine-level Packed E-Cell (PEC9) inverter under dynamical operation. Unlike previous tuning schemes which concentrate on extracting mathematical formulation of a controlled plant, this letter investigates a fuzzy Q-Learning agent for optimal design of PEC9. In first step, the fuzzy reinforcement learning is adopted to tune the MFNC controller in the simulation environment. In fact, the FQL algorithm finds the optimal policy based on a reward function for adjustment of the MFNC control coefficients to guarantee the grid-connectivity requirements under PEC9 dynamical operation are met. The experimental tests are conducted to assure efficiency and practicability of the designed multi-agent FQL-MFNC scheme on the single-phase grid-connected PEC9 inverter.

Three samples of high ordered AAO template were prepared via a two-step anodization procedure, the pore size was modified during the pore-widening process to tune the pore diameter to 50, 70, and 90 nm. Scanning electron microscopy (SEM) was adopted to gauge the pore diameter and the cell unit of the periodical hexagonal structure of the prepared AAO templates. In addition, the UV-vis spectrometer shows the variation of the absorbance spectrum for each pore size of the prepared AAO templates. To prove that the pore diameter (PD) and the intermediate layer (IL) could enhance the absorbance of the materials, a Lumerical FDTD solution was used by involving the exact experimental conditions of the AAO template. The resulting data show that a specific pore diameter with a specific intermediate layer can improve the absorbance spectrum of the materials. Thus, the results could serve the applications related to solar energy conversion (antireflective and photocatalyst) and photonics.

Recently, graphene has been adopted to replace other expansive materials in various devices that perform numerous functionalities in many industrial fields. Meanwhile, researchers are still investigating the amazing properties of graphene. Herein, reduced graphene oxide (rGO) has been successfully exfoliated directly using a graphite rod in a modified electrolyte including a table salt as a co-electrolyte. The structure of graphene obtained by using exfoliation methods shows a low ratio of O/C and confirms the high crystallinity of rGO. The thickness of rGO was adjusted during the drying of the drops of rGO solution and obtained about an 8-80 nm rGO thick. The increased O/C ratio and crystallinity enhancement could be attributed to the quantum confinement effect. Further investigations to estimate the decay constant of the optical band gap during the thinning of the rGO layers show that the optical band gap was associated with thicknesses of the rGO at a decay constant of 0.3367±0.00205. These results would be crucial in several optical applications that depend on the thicknesses and the band gap.

The objective of this study is to investigate the effectiveness of creating and using an educational animated video on Jordanian children’s conceptual understanding of and attitude towards the roles and functions of future innovations in human society. Mayer’s principles of the Cognitive Theory of Multimedia Learning (CTML) guide the design and development of the animated video and the intervention. The participants are 112 children in age 10 to 11 years old from three different districts of Jordan. The study uses a qualitative experiment design. The children were separated into experimental groups and control groups to investigate two different pedagogical environments. The first experimental group uses animated video within Multimedia Learning intervention. The second control group uses the Traditional Teaching method. To measure the intervention’s effects, the study uses pre- and post-conceptual understanding test and post-attitude questionnaires. To find out more about the experiences with using the animated video within Multimedia Learning intervention, a sub-sample of children were interviewed. The findings of the study reveal that creating and using animation have a statistically significant effect, at the 0.05 level, on children’s conceptual understanding of future innovations and future challenges. Their attitudes towards learning about the future innovations are positive.

Sustainability includes social, economic, and ecological responsibilities. The worldwide concern about sustainability is increasing, especially for those issues related to the ecological domain. Any organization wishing to survive and sustain its business should consider sustainability pillars within daily activities. Therefore, this study is directed to investigate how consumers’ identification, involvement, and commitment to sustainability affect entrepreneurship. This paper uses a quantitative cross-sectional method to collect the data from 400 respondents in Jordan. The results show a correlation between consumers’ level of involvement, identification, commitment, and sustainability components (economy-driven venture, society-driven venture, and ecology-driven venture). Moreover, commitment has the highest effect on customers’ intentions and behavior; identification has the second highest effect, while involvement does not significantly affect both customers’ intentions and behavior. The study recommends that all organizations, whatever they do and wherever they conduct their business, should consider sustainability pillars within their strategies and daily practices. The sustainability-driven ventures should not only attract the required customer segmentation via social media, but also enhance, strengthen, and engage their sense of identification, commitment, and belonging.

Purpose: To study the effect of the coronavirus disease 2019 (COVID-19)–related lockdown on myopia progression of school-aged children, comparing across the years and within different age groups. Methods: This was a retrospective chart review of school-aged children with myopia who presented to the pediatric ophthalmology clinic at the American University of Beirut between January 2020 and December 2021 (during COVID-19 lockdown). Annual myopia progression rate (back to January 2016) was computed by dividing the absolute value of the spherical equivalent (SE) difference of two consecutive visits by the duration (in years). Demographic data were retrieved. Patients were then divided into three age groups (3 to 10, 11 to 14, and 15 to 18 years) for analysis. Results: A total of 443 charts of myopic school-aged children were reviewed. Their average age was 11.81 ± 3.67 years with an average of 3.85 ± 1.67 visits across the years. The mean myopic SE increased over time: SE in 2021 was significantly higher than the mean SE in 2016, 2017, 2018, and 2019. Mean SE in 2020 was significantly higher than that in 2016 and 2017. There was no statistically significant difference in the mean annual progression (in diopters/year). For the 3 to 10 years group, the annual SE progression tended to be highest for 2020–2021 and 2019–2020 compared to previous years. Conclusions: Children had more myopia in 2021 and 2020 (during lockdown) compared to previous years. The myopia annual progression tended to be highest in 2020–2021, especially for the younger age group, but the difference was not statistically significant. [ J Pediatr Ophthalmol Strabismus . 20XX;XX(X):XX–XX.]

We aim to assess the influence of obesity on gastroparesis (GP) hospitalizations in the United States (US).The National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of GP. They were subdivided based on the presence or absence of obesity (body mass index30). Hospitalization characteristics, procedural differences, all-cause inpatient mortality, mean length of stay (LOS), and mean total hospital charge (THC) were identified and compared.From 2007-2017, there were 140 293 obese GP hospitalizations accounting for 13.75% of all GP hospitalizations in the US. Obese GP hospitalizations were predominantly female (76.11% vs 64.36%,In the US, compared to non-obese, a higher proportion of obese GP hospitalizations were female and Blacks. Obese GP hospitalizations also had higher THC, LOS, and rates of upper endoscopy.

The rapidly evolving urbanization is generating unprecedented travel demand, notably in intercity travel. With increasing challenges in motorized traffic, innovative and sustainable transport modes are more than ever necessary. The Hyperloop system is an emerging transportation mode with the potential to change long–distance commutes, especially between cities. There is a need for, but also gap in, understanding this potentially emerging transport mode. This study aims at filling this gap by deploying a stated preference study in Germany, in which data was collected for 786 respondents with 5640 scenarios, to investigate the factors impacting users’ preferences towards Hyperloop systems. Models were developed to examine factors impacting the immediate Hyperloop adoption (in the first year of its implementation), but also the choice between Hyperloop and other long–distance travel modes, such as airplanes and high-speed trains. Results indicate that mode-related characteristics (travel time, travel cost, safety), individual characteristics (gender, income level, availability of a driving license, access to a car, familiarity with the Hyperloop system), the current satisfaction level with high-speed trains and airplanes, and personality traits (confidence, affinity to technology) are the most significant factors in the choice and early adoption of Hyperloop systems.

This paper proposes a sliding fractional order (SFO) control strategy to provide robustness feature for integrating a multilevel converter into power grid under the system parameter uncertainties, nonlinear load alterations and grid voltage sag. All dynamics achieved from the input capacitors and output inductances of the multilevel converter are utilized to design the proposed sliding fractional surfaces (SFSs) such that a robust operation of the grid-tied converter-based system is achieved. Then, a SFS-based Lyapunov function is brought forward to assess the proposed controller stability. A thorough analysis of the Lyapunov function is carried out for distinguishing suitable boundaries of the controller coefficients when the error components of the system state variables are changed, accordingly. Using the derivative of Lyapunov function and SFS, a comprehensive evaluation is executed to detail regulation procedure for the robustness and fractional PI controller coefficients. Finally, a closed-loop system using the converter current dynamics aims to discern the differences between different values of fractional order (FO). Experimental tests using dSPACE-1202 along with MATLAB/Simulink simulations are employed to verify the effectiveness of the proposed control technique for providing proper harmonic compensation, enhanced power quality, unity power factor, voltage sag tolerance, and very low THD grid current.

Nascent mumpreneur is a mother with one or more children coming up with a new venture to support herself and her family. The debate about the motivation for mumpreneurs to start their new business is going on and underresearched. Therefore, this study aims to define the major motivational factors that influence mumpreneurial intentions in Jordan, specifically amongst nascent mumpreneurs. Maslow’s hierarchy of needs was employed to discover these factors. This quantitative cross-sectional study uses convenience sampling to collect data from 81 nascent mumpreneurs through an online survey that included nascent Jordanian mumpreneurs. After confirming the validity and reliability of the tool, the multiple regressions test was used to test the hypotheses. The results indicate a strong relationship between Maslow’s needs and mumpreneurial intentions, where r equals 0.74, and Maslow’s needs can explain 54% of changes in mumpreneurial intentions, where R2 is 0.54. The results also show that the need for esteem influences mumpreneurs’ intentions (β = 0.43), and the need for self-actualization influences mumpreneurs’ intentions (β = 0.80). At the same time, the physiological needs, the security needs, and the need for belonging do not influence mumpreneurial intentions, where significance is 0.74, 0.09, and 0.09, respectively. Moreover, the results show that the marital status and level of education do not moderate the influence of Maslow’s theory of needs on mumpreneurs’ intentions, where the significance for both is more than 0.05. Finally, the study recommends developing mumpreneurial incubators and providing workshops and training for potential mumpreneurs.

Tricuspid valve (TV) surgery remains understudied and little data exist describing the surgical indications, outcomes, and prognostic factors for pediatric patients with non-Ebstein 2-ventricle congenital TV lesions. This study aims to describe early and late outcomes of pediatric patients with non-Ebstein congenital TV lesions undergoing isolated TV procedures at a single institution.All patients who underwent TV surgery for non-Ebstein congenital TV disease between 2006 and 2018 were included. Patients who had missing preoperative data, patients with single-ventricle physiology, congenitally corrected transposition of the great arteries, and patients undergoing TV intervention as part of repair of an atrioventricular canal defect were excluded. The primary end point was the occurrence of TV reintervention or TV regurgitation (TR) ≥ moderate.A total of 85 patients were included. The tricuspid lesion was isolated TR in 80 (94.1%), isolated tricuspid stenosis in 3 (3.5%) and mixed disease in 2 (2.4%) patients. Median age at surgery was 33 years (interquartile range, 12-53 years). TV repair and TV replacement were performed in 66 (77.6%) and 19 (22.4%) patients, respectively. One (1.2%) patient underwent TV reoperation during the same admission. There was no in-hospital mortality. Median follow-up was 3.3 years (interquartile range, 0.1-4.7 years). The overall cumulative incidence of TV reintervention or TR deemed moderate or greater at 1, 3, and 5 years was 3% ± 2%, 11% ± 4%, and 20% ± 8%. In multivariable analysis, age younger than 12 years (TV surgery in patients with non-Ebstein congenital TV disease can be performed with good outcomes. TV reintervention or TR deemed moderate or greater occurred in 20% of patients on midterm follow-up. Patients younger than age 12 years are at higher risk for recurrent TR or TV reintervention, whereas preoperative MR deemed moderate or greater increases this risk, especially in patients older than age 12 years. There was no difference in outcomes between TV replacement and repair.

Understanding the evolution of Coronal Mass Rejections is a challenging endeavor. Imagers provide snapshots of the eruptions, in-situ instruments provide a one-dimensional time series during encounters, theories are not up to date with current observations, and there is a lack of dedicated missions providing multi-spacecraft measurements. All of these factors are severely impacting our understanding of the ever-changing dynamics of CMEs during evolution. However, a wealth of valuable data exist and novel techniques to extract information are always needed. In this work, we discuss different approaches to making the most of the available data, through data analysis techniques, improving fitting techniques, and utilizing different spacecraft configurations. We also present recommendation on the needed measurements to adequately study and probe the structure and evolution of CMEs.&nbsp, The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Coronal mass ejections are observed remotely by coronagraphs with angular widths, for the "flux rope", of 60-90 deg. Past studies from single events measured by two spacecraft at the same heliocentric distance or statistical studies of events measured by two spacecraft at different distances have revealed that the angular width of CME magnetic ejecta may be 40-60 deg near 1 AU. Here, we present a more in-depth analysis of CME measurements by STEREO-A and Wind in 2020-2022 when the two spacecraft separation decreased from 60 to 20 deg. We find that multi-spacecraft measurements are rare, even for two spacecraft at 1 AU separated by 25-30 deg. We discuss how this affects future mission concepts and how it reveals that dedicated multi-spacecraft missions with spacecraft separations of 20 degrees or less are needed to advance our understanding of CMEs.&nbsp, The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Post-translational modifications of histone tails alter chromatin accessibility to regulate gene expression. Some viruses exploit the importance of histone modifications by expressing histone mimetic proteins that contain histone-like sequences to sequester complexes that recognize modified histones. Here we identify an evolutionarily conserved and ubiquitously expressed, endogenous mammalian protein Nucleolar protein 16 (NOP16) that functions as a H3K27 mimic. NOP16 binds to EED in the H3K27 trimethylation PRC2 complex and to the H3K27 demethylase JMJD3. NOP16 knockout selectively globally increases H3K27me3, a heterochromatin mark, without altering methylation of H3K4, H3K9, or H3K36 or acetylation of H3K27. NOP16 is overexpressed and linked to poor prognosis in breast cancer. Depletion of NOP16 in breast cancer cell lines causes cell cycle arrest, decreases cell proliferation and selectively decreases expression of E2F target genes and of genes involved in cell cycle, growth and apoptosis. Conversely, ectopic NOP16 expression in triple negative breast cancer cell lines increases cell proliferation, cell migration and invasivity in vitro and tumor growth in vivo , while NOP16 knockout or knockdown has the opposite effect. Thus, NOP16 is a histone mimic that competes with Histone H3 for H3K27 methylation and demethylation. When it is overexpressed in cancer, it derepresses genes that promote cell cycle progression to augment breast cancer growth.

We identified trends of inpatient therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the United States (US), focusing on outcomes related to specific patient demographics.The National Inpatient Sample was utilized to identify all adult inpatient ERCP in the US between 2007-2018. Trends of utilization and adverse outcomes were highlighted. P-values ≤ 0.05 were considered statistically significant.We noted a rising trend for total inpatient ERCP in the US from 126,921 in 2007 to 165,555 in 2018 (p = 0.0004), with a significant increase in utilization for Blacks, Hispanics, and Asians. Despite an increasing comorbidity burden [Charlson Comorbidity Index (CCI) score ≥ 2], the overall inpatient mortality declined from 1.56% [2007] to 1.46% [2018] without a statistically significant trend (p = 0.14). Moreover, there was a rising trend of inpatient mortality for Black and Hispanic populations, while a decline was noted for Asians. After a comparative analysis, we noted higher rates of inpatient mortality for Blacks (2.4% vs 1.82%, p = 0.0112) and Hispanics (1.17% vs 0.83%, p = 0.0052) at urban teaching hospitals between July toand September compared to the October to June study period; however, we did not find a statistically significant difference for the Asian cohort (1.9% vs 2.10%, p = 0.56). The mean length of stay (LOS) decreased from 7 days in 2007 to 6 days in 2018 (p 0.0001), while the mean total hospital charge (THC) increased from $48,883 in 2007 to $85,909 in 2018 (p 0.0001) for inpatient ERCPs. Compared to the 2015-2018 study period, we noted higher rates of post-ERCP pancreatitis (27.76% vs 17.25%, p 0.0001) from 2007-2014.Therapeutic ERCP utilization and inpatient mortality were on the rise for a subset of the American minority population, including Black and Hispanics.

PurposeThis study examined the conceptions of assessment and its relationship to self-regulation and self-confidence among pre-service teachers.Design/methodology/approachParticipants were 278 pre-service students attending a teacher's college in Bahrain. This study employed the structural equation modeling (SEM) approach to investigate the relationships among the observed variables.FindingsThe results revealed that the conceptions of assessment had positively impacted the academic achievements of students who were accountable. In addition, the conceptions that made schools accountable had a positive relationship with academic achievement, whereas students who ignored the assessment, received a negative effect on self-regulation.Research limitations/implicationsThe generalization of the results to other populations in Bahrain should be made with caution since this study involved a relatively small number of students from Bahrain. Policymakers might be encouraged to consider students' appropriate response to their conceptions of assessment when assessments are being developed.Originality/valueThis study might encourage educators and policymakers in Bahrain to develop strategies to further improve students' self-confidence, self-regulation, and academic achievement.

There are many methods for synthesizing magnetite nanoparticles. Most methods take a long time, and the result is undesirable. In this paper a green method was used to synthesize nanoparticles because it takes a short time and is both straightforward and eco-friendly. It is done by adding : =1:2 molar ratio solution with different amounts of extract and different amounts of NaOH solution for 20 min at different temperatures, in hotplate stirrers, to control their relative size. UV-Vis spectroscopy, vibrating sample magnetometer technique (VSM), transmission electron microscopy (TEM), and X-ray diffraction (XRD) were used to characterize the magnetite nanoparticles. The result confirms that the changes in amounts of NaOH and extract led to a change in the pH of a solution and that the increase in amounts of the extract caused the low addition of NaOH. These changes influenced the process of synthesis and characterization. The Uv-vis analysis confirms that the surface plasmon resonance had a highly visible brad peak in the 290–460 nm range, as well as a peak shift to shorter wavelengths (blue shift) with a pH change and a peak shift to longer wavelengths (red shift) with a temperature change. TEM imaging confirms that all the synthesized had a spherical shape with size changed according to a parameter change of within 40–9 nm. Magnetic analysis showed the magnetite nanoparticles synthesized have smaller sizes and are superparamagnetic with the influence of particle size on the magnetic properties, including Hc, Ms, and Mr.

This study is designed to isolate and molecular identification of C. neoformans, C. neoformans is pathogenic yeast and effect immunocompromised and immunocompetent. Methods: collect 50 samples from pigeon dropping and 50 samples from pigeon fanciers (sputum). The collection time was extended from November 2021 to February 2022, then culture at SDA, BSA, Cryptococcus Differential agar, esculin agar, Eucalyptus leaves agar media and Brain heart infusion agar with methyldopa, biochemical test including urease test and methyldopa, and then confirm identification by molecular identification by PCR technique sequencing and genetic analysis. The results showed that 3 swaps taken from sputum of human included cryptococcus neoformans and 6 swaps from bird dropping included cryptococcus neoformans. This study indicated that the virulence and normal habitat of cryptococcus neoformans. These results indicate that there may be a risk for human exposure to cryptococcal disease due to inhalation of basidiospores from dropping of pigeon in pigeon houses

The purpose of this study is to investigate the impact of intrapreneurship on the performance of telecom operators in Jordan. Three different dimensions are investigated that represent the independent variable of intrapreneurship – corporate culture, corporate entrepreneurship, and re-engineering corporate thinking, while the dependent variable performance included five dimensions such as the volume of production, sales volume, production process, diversification, and employee enhancement. A quantitative method was used; a survey was targeted at Telecom Jordan employees who were participating in the company’s intrapreneurial program Oz. 140 employees participated in the intrapreneurial program as a comprehensive population, and 102 questionnaire forms were retrieved. The findings showed that there is a significant effect of intrapreneurship on the performance of Telecom Jordan. The coefficient of determination (R2) is 0.394, indicating that the intrapreneurship explains 39.4% of the change in operators’ performance. Moreover, the results revealed that the highest effect of intrapreneurship is on employee enhancement, followed by the process of production, sales volume, the volume of production, and diversification, respectively. The study highly recommended giving more attention to the intrapreneurial studio, as it is considered a factory of various diversified ideas.

Aiming at delivering power to sensitive loads with an enhanced level of reliability and quality, a compact multilevel battery-based electric spring (ES2) topology founded on the Packed E-Cell (PEC) inverter and an artificial neural network (ANN) based control strategy are introduced. This multilevel ES2 overcomes the limitations of the two-level ES2s and offers key features in the area of electric spring that have not been considered before. From the reliability point of view, the PEC-based ES2 (PEC-ES2) has the capability of instant nine to five-level operation under its bidirectional switch faulty condition. Regarding the power quality, in comparison with the half or full bridge ES2 topologies, PEC-ES2 has switches with halved voltage rating, lower harmonic content in its output current and voltage, considerably lower switching frequency, higher power applications, etc. The proposed intelligent ANN-based controller can also tune and stabilize both the grid voltage and responsive load setup power factor independently with improved dynamic performance. The operation and viability of the proposed ES2 configuration and controller, have been also tested extensively.